SV_In Class_Central Perfusion.pdf

Central Perfusion Lecturer: Beth Flott, EdD, RN  Perfusion Definition - Flow of blood through arteries and capillaries delivering nutrients and oxygen to cells and removing cellular waste products Antecedents Defining Characteristics Positive Consequences Risk Factors Negative...

Central Perfusion Lecturer: Beth Flott, EdD, RN  Perfusion Definition - Flow of blood through arteries and capillaries delivering nutrients and oxygen to cells and removing cellular waste products Antecedents Defining Characteristics Positive Consequences Risk Factors Negative Consequences Interrelated Concepts Exemplars Perfusion  Perfusion Extent of tissue damage from impaired perfusion depends upon the size and location of the blood vessel and whether the blood supply is reduced or completely interrupted Ischemia occurs when blood supply is available but decreased (impaired perfusion) Infarction occurs with prolonged ischemia, eventually leading to necrosis and death of affected cells (no perfusion) Perfusion - Central Generated by Cardiac Output Cardiac output is an outcome of coordinated effects of electrical and mechanical factors that move blood through the heart into the peripheral vascular system Propels blood to all organs and their tissues from patent arteries through capillaries and returns the blood to the heart through patent veins Perfusion - Central Contraction of the Ventricles Perfusion - Central Contraction of the Ventricles (Systole ) Closure of the Mitral and Tricuspid Ventricles relax to fill with blood Valves (preventing a backflow into the atria) (pressure is higher in the atria causing the movement of blood from the atria to the ventricles) – The Forces the aortic and pulmonic valves higher atrial pressures passively to open = ejection of blood into the open the mitral and tricuspid valves aorta (LV) & pulmonary arteries (RV) allowing blood to fill the ventricles As blood is ejected the ventricular pressure decreases causing aortic/pulmonic valves to close Perfusion - Central Perfusion Risk Factors Modifiable Non-modifiable Smoking (nicotine vasoconstricts) Age Elevated Serum Lipids Gender: men > women Sedentary Lifestyle Genetics: family history Obesity Race – African-Americans Diabetes Mellitus Hypertension Alcohol Consumption Chronic Stress Perfusion - Central What are signs and symptoms you would anticipate seeing in your patients that exhibit impaired central perfusion? Vital Signs Cardiac Assessment Neurological Assessment Diagnostic Tests Perfusion  Perfusion - Central Impaired Any occlusion or constriction of coronary arteries that reduces blood flow to the myocardium can result in myocardial infarction and thus ↓ cardiac output Altered impulse conduction through the heart (SA to AV) interrupts the electrical function for contraction Malfunction of heart valves impairs flow of blood through the heart Shock – inability of central perfusion to supply blood to peripheral tissues  Perfusion - Central Cardiac Dysrhythmias CO= HR x SV Perfusion to vital organs reduced Can be fatal Perfusion - Central Sinus bradycardia Sinus tachycardia Asystole Atrial fibrillation Ventricular tachycardia Ventricular fibrillation Perfusion - Central Atrial Fibrillation https://www.youtube.com/watch?v=0FufW_MZMa4 Ventricular Tachycardia https://www.youtube.com/watch?v=C1smdOKd4Ds Ventricular Fibrillation https://www.youtube.com/watch?v=BSf_YIyZzi8  Perfusion - Central Impaired Any occlusion or constriction of coronary arteries that reduces blood flow to the myocardium can result in myocardial infarction and thus ↓ cardiac output Altered impulse conduction through the heart (SA to AV) interrupts the electrical function for contraction Malfunction of heart valves impairs flow of blood through the heart Shock – inability of central perfusion to supply blood to peripheral tissues Perfusion - Arteriosclerosis Atherosclerosis Central Coronary Artery Disease (CAD) Acute Coronary Syndrome = Ischemia/Myocardial Infarction Perfusion - Central Coronary Artery Disease (CAD) Signs and symptoms? Myocardial Ischemia Signs and symptoms? Myocardial Infarction Signs and symptoms? Perfusion - Central Perfusion - Central  Perfusion - Central Diagnostics Troponin - proteins found in skeletal and cardiac muscles that are released into the bloodstream Troponin I -